Healthcare Flexible Spending Account (FSA)

The Healthcare FSA is a program that allows you to set aside money, before taxes, from your paycheck to pay for health-related expenses not covered by insurance. The great advantage is that you pay no federal taxes on your contributions. 


If you put in $1,000 and are in a 20 percent federal tax bracket, you save $200 ($1,000 x 20% = $200).
The IRS has modified the "use-it-or-lose-it" provision to now allow Healthcare FSA participants to roll over up to $500 in unused funds.
If you or your spouse and/or eligible dependents go to the doctor or dentist, take medication or wear glasses, the Healthcare FSA may save you money whether you have insurance or not.
Contributions to the FSA are subject to New Jersey State Income Tax. 

How the Accounts Work 

Setting up the Account

As an enrollee in the FSA plan, you are provided with a PayFlex Card®. You receive one card and have the option to order additional cards for eligible dependents by contacting PayFlex at (800) 284-4885 or online at Payflex. The PayFlex Card® may remain valid for up to a five year period. If you re-elect the FSA from year-to-year, the PayFlex Card® will be loaded with your new election amount each January 1. 
When you use the card, it debits your FSA automatically. The card can be used to pay for eligible products and services at any qualifying provider location where MasterCard is accepted, including hospitals, physician offices, dental offices, vision service locations and pharmacies. You are not required to use the card. However, the advantage of using the card is that you are accessing your FSA at the point-of-service, so you do not have to pay out-of-pocket or complete a claim form. After using the card, certain services may require that you provide documentation to PayFlex to substantiate the claim to comply with IRS regulations. If a claim needs to be substantiated, you will receive a notification from PayFlex.

Electing Contributions Annually

For 2017, you may choose to contribute between $100 and $2,600 into the account. Elections do not automatically carry over each year. You must make a new election through HR Self Service each year to participate in the Healthcare FSA, even if you are participating in the current year. 


When you have an eligible expense, you will have the option of:
  • using the PayFlex debit card
  • filing the claim online on the PayFlex website; direct deposit of the reimbursement is availble to your personal checking or savings account
  • scanning, faxing or mailing your receipt with the medical care reimbursement claim form 
You can arrange for direct deposit from your expense account to your personal check or savings account.
You have until March 31 of the year following the calendar year to submit claims for eligible expenses you incurred during the previous calendar year. Princeton will allow balances of $50 up to a maximum of $500 of unused funds to be automatically rolled over each year. Any amounts under $50 or over $500 will be forfeited.

Estimating Your FSA Expenses

Contributions to your FSA depend on your household needs. 
  • Think about how many copayments you will have for physician visits or prescriptions.
  • Will you pay a deductible?
  • Perhaps you expect a large dental, orthodontic, e.g., braces, or vision expense, e.g., LASIK surgery.
Estimate your expenses carefully because the IRS does not allow you to roll over funds in excess of $500. Any money left in the account under $50 or over $500 will be forfeited.

Expense Account Worksheet

Use the worksheet below to calculate your health care (medical, dental, vision) expenses for the calendar plan year, January 1 - December 31.
You can calculate your savings on the website of our third party administrator, PayFlex.
  • Do not include itemized medical deductions you plan to claim on your annual tax return.
  • Include the health expenses of your spouse and eligible dependents.

Everyday Health Expenses (Not Covered by Insurance)

Dental (non-cosmetic)
Vision (prescription glasses, contact lenses, exams, LASIK, supplies)
Prescription drugs
Over-the-counter medication is no longer elibile for reimbursement through HBEA unless you have a prescription from a doctor.  This rule does not apply to items for medical care that are not medicines or drugs.  For example, equipment such as crutches, supplies such as  bandages and diagnostic devices such as blood sugar test kits will still quality for reimbursement.

Expenses Within Your Medical Coverage

Deductible (amount you pay before the plan begins to pay)
Co-insurance (percentage you pay after deductible is met)
Copayments (for doctor’s office visits)

Other Expenses

Orthodontia (only incurred expenses)
LASIK eye surgery
Chiropractic care
Total estimated out-of-pocket expenses
You have until March 31 of the subsequent calendar year to submit claims for health care expenses you have incurred during the previous calendar year. Otherwise, any money left in your account under $50 or over $500 will be forfeited

You can count on support from knowledgeable and responsive HR staff when you have a benefits question or problem. Just call or e-mail us. We’re here to help!